The present invention relates to a method, a kit and an applicator for performing a surgical occlusion on a human or animal body. More particularly, in accordance with the invention use is made e.g. of elongated and flexible, bundle-strap type occlusion ties which are passed and locked into occlusion loops around a tissue.
A surgical operation (on a human or animal body) frequently involves the sectioning of tissues containing vessels. For example, such sectioning is necessary in order to remove organs, or parts thereof, from the body. If the tissue to be sectioned is thin and superficial and the vessels are correspondingly small, sectioning normally does not involve any difficulties when employing conventional ligation/occlusion techniques.
Generally, present-day sectioning and occlusion techniques comprise the following two alternative procedures. According to the first alternative, one or more ligatures are applied on each side of the intended sectioning area, whereupon the tissue is sectioned. According to the second alternative, two pairs of pair of tissue forceps are initially applied at a certain mutual distance over the intended sectioning area, whereupon the tissue is sectioned between the forceps, and a ligature is performed on the opposite side of the respective forceps, which are then finally removed.
Normally, a ligature is a suture thread which is applied around the tissue and knotted to establish a firm seal or occlusion. When a suture is to be applied around a free-prepared non-sectioned tissue, a pair of curved pliers is first introduced under the tissue from one side. At the other side of the tissue, the pliers are opened to grasp one end of a suture thread which by some other means, such as a pair of tissue forceps, has been introduced into the operation area. The pliers are then withdrawn, taking with them the suture thread which thus remains in its proper place around the tissue. Such application of the suture thread has to be performed with great care so as not to damage the tissue and adjacent organs. After the suture thread thus has been positioned around the tissue, the actual knotting is performed, the first knot accomplishing a sealing function and the succeeding knots accomplishing a locking function. This procedure of applying and locking a suture thread has to be repeated for each ligature, i.e. at least twice. Ligation outside a pair forceps on a non-sectioned tissue is performed in practically the same way.
However, when the operation is performed in a deep and narrow area, it is sometimes difficult and troublesome to introduce the suture around the tissue and establish a firm and secure ligature. One reason could be that the suture is not sufficiently tightened before knotting. Also, the knot itself could be insufficiently strong and thus come loose, so that the ligature slides off, involving a risk of peroperative or postoperative bleeding. If bleeding occurs during the operation, a hemostatic instrument has to be applied more or less blindly with a risk of damaging organs. A postoperative sliding-off of a ligature may necessitate a further and difficult operation.
U.S. Pat. No. 4 955 913 discloses a bundle-strap type, one-piece surgical tie including a retaining head from which a tongue extends. The tongue is to be inserted into the retaining head so as to form a loop around living tissue and ligate such tissue, especially during the performance of feline and canine hysterectomies. The retaining head includes locking means for receiving the tongue and retaining it against a loop-opening movement. The tongue is formed as an elongated and flexible flat member having a smooth outer side and a toothed opposite side for engaging the locking means of the retaining head. The document does not disclose any special technique for applying the ties.